Elisabet Borg, May 2021

Information to test leaders

Before the exercise test is run it is important that the participant/patient is familiarized with the scale and the original instruction provided together with the scale. The part on perceived exertion will function as a cognitive reference regardless of the intended use in the study. Show the scale to the participant and let her/him read the instruction. It is also possible to read the instruction loud to the participant.

Sometimes there might be need for an additional instruction (for example when a Borg CR Scale® is used for other variables than perceived exertion). This can then be added after the original instruction. BorgPerception AB will be happy to advice on this topic.

The traditional way to use any of the Borg scales is in paper format but a similar procedure can be followed if an electronic format is being used. The scale can preferably be visible to the participant during the whole exercise test. If this is not possible, the scale can be shown to the participant just before each rating. 

When it is time for the participant/patient to make a rating the test leader might point to the scale/show the scale and say (with whatever symptom should be rated):

  • “Please look at the scale. What is your feeling of overall exertion/leg exertion/breathlessness/dyspnea/muscle pain/chest pain/etc…, right now?

The Borg RPE scale®

Intended for Ratings of Perceived Exertion. The oldest of the Borg scales. Participants may only use the values on the scale, at or between the words. (If necessary, for example for research purposes, half values can be allowed.)

The Borg CR Scale® (CR10)

A general intensity scale that can be used for most kinds of perceptions, feelings and emotions with intensity variation (most commonly, however, perceived exertion, fatigue, breathlessness, dyspnea, and pain.) The scale is continuous and all values along the scales are allowed (also decimals.)

On the scale, the value “10”, is anchored in the participants previous experience of a maximal exertion. For example, this could be the feeling of effort from trying to lift something so heavy that you only almost manage to lift it, or from running as fast as you can for a couple of hundred meters so that you feel completely exhausted. To avoid a ceiling effect the “absolute maximum” is placed outside of the actual scale. In rare cases a patient/participant may need to use values above 10 (however, a value beyond 15 is normally not accepted unless in very extreme cases and then usually for pain.)

The Borg centiMax® Scale (CR100)

A general intensity scale similar in construction to the CR10 (above) but more finely graded. The scale is administered in the same way as the CR10.

Because the Borg CR scale® (CR10 and also CR100) are general intensity scales, they can be used for a multitude of different perceptions, experiences and emptions. The scales have also been used for as different variables as back pain; loudness; aircraft noise; satiation; taste perception; putting force in golf; stress; symptoms of depression; hypernasality; and performance evaluation in diving.

How should the scale be administered in such varied situations? The original instructions should always be given to the participant. Because most people have experience of perceived exertion even to its maximum, this will function as a standardization/calibration procedure. After this a specific instruction should be given. In many cases it will be enough to explain what the participant will be doing and to ask the participant to now use the scale for this variable instead. For example, if traffic noise should be rated on the Borg centiMax® Scale (CR100):

  • “In these headphones you will hear a series of sounds that represent different kinds of traffic sounds. Your task will be to give a rating of how loud/how annoying/etc.  you perceive them to be. Please remember that 100 – Maximal corresponds to a Maximal perceived exertion.”

It is also possible to add a specific well defined reference level to the instruction for some variables. Such a reference level, however, needs to be well defined and have the highest possible interindividual agreement (lowest variability), which means that it does not necessarily have to be the maximal level. For loudness, for example, most people have never heard a “maximal” sound (and it would probably threaten their hearing), but for example “the sound of a police car passing on the street with its sirens on” might be a reference of perhaps 90 centiMax. To obtain such reference levels should, however, be done experimentally.  BorgPerception will be happy to give advice on how this could be done.